EP2753351B1 - Anti third party central memory t cells, methods of producing same and use of same in transplantation and disease treatment - Google Patents

Anti third party central memory t cells, methods of producing same and use of same in transplantation and disease treatment Download PDF

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EP2753351B1
EP2753351B1 EP12769743.1A EP12769743A EP2753351B1 EP 2753351 B1 EP2753351 B1 EP 2753351B1 EP 12769743 A EP12769743 A EP 12769743A EP 2753351 B1 EP2753351 B1 EP 2753351B1
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cells
party
cell
tcm
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French (fr)
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EP2753351A1 (en
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Yair Reisner
Yaki Eidelstein
Eran Ophir
Assaf Lask
Ran Afik
Noga Or-Geva
Esther Bachar-Lustig
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Yeda Research and Development Co Ltd
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Yeda Research and Development Co Ltd
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Definitions

  • the present invention in some embodiments thereof, relates to tolerance inducing and/or graft versus leukemia reactive anti-third party cells comprising central memory T-lymphocyte phenotype and, more particularly, but not exclusively, to methods of generating same and to the use of same in transplantation and in disease treatment.
  • Bone marrow (BM) transplantation offers a curative treatment for many patients with hematological malignancies and other hematological disorders.
  • the BM graft contains donor T cells which respond to the host antigens (Ags) and cause multi-system graft-versus-host disease (GVHD).
  • GVHD multi-system graft-versus-host disease
  • BMT bone marrow transplant
  • SCID severe combined immunodeficiency
  • T-depleted BM (TDBM) graft While in high risk leukemia patients such transplant-related mortality can be acceptable, it would be intolerable if applied to patients with a long life expectancy. Therefore, the use of reduced intensity conditioning, with less severe immune ablation, to enable engraftment of T-depleted BM (TDBM) graft, which is associated with reduced risk for GVHD, is warranted.
  • TDBM T-depleted BM
  • the establishment of donor type chimerism under such reduced conditioning represents a most desirable goal in transplantation biology, as it is generally associated with durable tolerance towards cells or tissues from the original donor. Yet, the marked levels of host immune cells surviving the mild preparatory regimens, represents a difficult barrier for the engraftment of donor cells.
  • G-CSF granulocytes colony stimulating factor
  • the CD34 "megadose" transplants raised interesting questions as to how these cells overcome the barrier presented by host cytotoxic T-lymphocyte precursors (CTL-p). This question was answered, in part, by the finding that cells within the CD34 fraction are endowed with potent veto activity [ Gur et al., Blood (2005) 105:2585-2593 ; Gur et al., Blood (2002) 99:4174-4181 ; Rachamim et al., Transplantation (1998) 65:1386-1393 ].
  • Other cell types have also been shown to mediate veto activity including T lymphocytes (e.g. CD8 + CTLs), natural killer cells and dendritic cells. Direct comparison of the veto reactivity of various cell types revealed that CTLs comprise the strongest veto effect [ Reich-Zeliger et al., J Immunol. (2004) 173:6654-6659 ].
  • PCT Publication No. WO 2007/023491 discloses the use of tolerogenic cells for reducing or preventing graft rejection of a non-syngeneic graft in a subject.
  • the tolerogenic cells disclosed e.g. CD4 + CD25 + cells
  • the graft e.g. bone marrow
  • the graft may be derived from any graft donor who is allogeneic or xenogeneic with the subject.
  • PCT Publication No. WO 2002/102971 discloses the use of cultured hematopoietic progenitor cells (HPC) comprising enhanced veto activity for inducing tolerance to a transplant transplanted from a donor to a recipient.
  • the tolerogenic cells disclosed preferably express CD33 and are administered prior to, concomitantly with or following transplantation of the transplant (e.g. cell or organ transplant).
  • PCT Publication No. WO 2002/043651 discloses the use of a non-GVHD inducing population of immune effector cells for disease treatment.
  • a first cell population e.g. T-lymphocytes
  • a second cell population being non-syngeneic with the subject and non-syngeneic with the first cell population (e.g. EBV-infected B-lymphocytes) under conditions which include IL-2 starvation followed by IL-2 supplementation.
  • the resultant immune effector cells may be used to treat diseases such as malignant diseases, viral diseases and autoimmune diseases.
  • U.S. Pat. No. 6,759,035 discloses methods of inhibiting graft rejection and inducing T cell tolerance in a solid organ transplant recipient.
  • the methods disclosed comprise removing peripheral blood mononuclear cells (PBMC) from a donor and recipient, culturing the donor and recipient cells together in the presence of a compound that induces T cell suppressor activity (e.g. TGF- ⁇ , IL-15 and IL-2), and administering the recipient suppressor T cells to the recipient along with the transplant to prevent the recipient's T cells from killing donor cells, thereby inducing tolerance and long term survival of the transplant.
  • PBMC peripheral blood mononuclear cells
  • U.S. Pat. No. 6,803,036 discloses methods for treating donor cells to ameliorate graft versus host disease in a recipient patient.
  • the methods disclosed comprise removing PBMCs from a donor and treating the cells with a suppressive composition (e.g. IL-10, IL-2, IL-4, IL-15 and TGF- ⁇ ) for a time sufficient to induce T cell tolerance.
  • a suppressive composition e.g. IL-10, IL-2, IL-4, IL-15 and TGF- ⁇
  • the cells are then introduced to a recipient patient.
  • the treated cells may be added to donor stem cells prior to introduction into the patient.
  • PCT Publication No. WO 2010/049935 disclosed an isolated population of cells comprising non-GVHD inducing anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and capable of homing to the lymph nodes following transplantation.
  • Tcm central memory T-lymphocyte
  • a method of generating an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and/or endowed with anti-disease activity, and capable of homing to the lymph nodes following transplantation, the method comprising: (a) contacting peripheral blood mononuclear cells (PBMC) with a third party antigen or antigens in the presence of IL-21 so as to allow enrichment of antigen reactive cells; and (b) culturing the cells resulting from step (a) in the presence of IL-21, IL-15 and IL-7 in an antigen free environment so as to allow proliferation of cells comprising the central memory T-lymphocyte (Tcm) phenotype, thereby generating the isolated population of cells.
  • PBMC peripheral blood mononuclear cells
  • Tcm central memory T-lymphocyte
  • a method of generating an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and/or endowed with graft-versus-leukemia (GVL) activity, and capable of homing to the lymph nodes following transplantation, the method comprising: (a) treating non-adherent peripheral blood mononuclear cells (PBMC) with an agent capable of depleting CD4+ and/or CD56+ cells so as to obtain CD8+ T cells; (b) contacting the CD8+ T cells with third party dendritic cells in the presence of IL-21 for 12 hours to 5 days so as to allow enrichment of antigen reactive cells; (c) culturing the cells resulting from step (b) with the third party dendritic cells in the presence of IL-21, IL-15 and IL-7 for 12 hours to 3 days; and (d) culturing the cells
  • a method of generating an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being endowed with anti-disease activity, and capable of homing to the lymph nodes following transplantation, the method comprising: (a) treating non-adherent peripheral blood mononuclear cells (PBMC) with an agent capable of depleting CD4+ and/or CD56+ cells so as to obtain CD8+ T cells; (b) contacting the CD8+ T cells with non-syngeneic dendritic cells in the presence of IL-21 for 12 hours to 5 days so as to allow enrichment of antigen reactive cells; (c) culturing the cells resulting from step (b) with the non-syngeneic dendritic cells in the presence of IL-21, IL-15 and IL-7 for 12 hours to 3 days; and (d) culturing the cells resulting from step (c
  • an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, wherein at least 50 % of the isolated population of cells are CD3+CD8+ cells of which at least 50 % comprise a CD3 + , CD8 + , CD62L + , CD45RA - , CD45RO + signature, and further wherein the cells are tolerance-inducing cells and/or endowed with anti-disease activity, and capable of homing to the lymph nodes following transplantation.
  • Tcm central memory T-lymphocyte
  • an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and/or endowed with anti-disease activity, and capable of homing to the lymph nodes following transplantation, generated according to the present methods.
  • Tcm central memory T-lymphocyte
  • a method of treating a subject in need of a cell or tissue transplantation comprising: (a) transplanting a cell or tissue transplant into the subject; and (b) administering to the subject a therapeutically effective amount of the isolated population of cells of the present invention, thereby treating the subject.
  • a method of treating a subject in need of an immature hematopoietic cell transplantation comprising: (a) transplanting immature hematopoietic cells into the subject; and (b) administering to the subject a therapeutically effective amount of the isolated population of cells of the present invention, thereby treating the subject.
  • the method further comprises depleting non-adherent cells from the PBMC prior to step (a).
  • the method further comprises depleting CD4+ and/or CD56+ cells from the PBMC prior to step (a).
  • the method further comprises selecting CD45RA+ and/or CD45RO- cells from the PBMC prior to step (a).
  • the PBMC comprise CD8+ T cells.
  • the method further comprises culturing the cells resulting from step (a) with a third party antigen or antigens in the presence of IL-21, IL-15 and IL-7 following step (a) and prior to step (b).
  • the third party antigen or antigens comprise dendritic cells.
  • the dendritic cells are irradiated dendritic cells.
  • the third party antigen or antigens is selected from the group consisting of third party cells, a cell antigen, a viral antigen, a bacterial antigen, a protein extract, a purified protein and a synthetic peptide presented by autologous presenting cells, non-autologous presenting cells or on an artificial vehicle or on artificial antigen presenting cells.
  • the third party cells are stimulatory cells selected from the group consisting of cells purified from peripheral blood lymphocytes, spleen or lymph nodes, cytokine-mobilized PBLs, in vitro expanded antigen-presenting cells (APC), in vitro expanded dendritic cells and artificial antigen presenting cells.
  • stimulatory cells selected from the group consisting of cells purified from peripheral blood lymphocytes, spleen or lymph nodes, cytokine-mobilized PBLs, in vitro expanded antigen-presenting cells (APC), in vitro expanded dendritic cells and artificial antigen presenting cells.
  • the method further comprises selecting CD45RA+ and/or CD45RO- cells from the PBMC following step (a) and prior to step (b).
  • the CD8+ T cells comprise naive CD8+ T cells.
  • the dendritic cells comprise in vitro expanded dendritic cells.
  • the dendritic cells comprise irradiated dendritic cells.
  • the contacting in the presence of IL-21 is effected for 12 hours to 5 days.
  • the contacting in the presence of IL-21 is effected for 2-3 days.
  • the contacting in the presence of IL-21 is effected for 3 days.
  • the method further comprises selecting for activated cells following step (a) and prior to step (b).
  • the method further comprises selecting for activated cells following step (b) and prior to step (c).
  • the selecting for activated cells is effected by selection of CD137+ and/or CD25+ cells.
  • the selecting for activated cells is effected 12-72 hours after the contacting.
  • the culturing with the third party antigen or antigens in the presence of IL-21, IL-15 and IL-7 is effected for 12 hours to 3 days.
  • the presence of IL-21, IL-15 and IL-7 in the antigen free environment is effected for 5-20 days.
  • the culturing in the presence of IL-21, IL-15 and IL-7 in the antigen free environment is effected for 7-11 days.
  • the method further comprises depleting alloreactive cells following step (b).
  • the method further comprises depleting alloreactive cells following step (d).
  • the depleting the alloreactive cells is effected by depletion of CD137+ and/or CD25+ cells following contacting the cells comprising the central memory T-lymphocyte (Tcm) with host antigen presenting cells (APCs).
  • Tcm central memory T-lymphocyte
  • APCs host antigen presenting cells
  • the peripheral blood mononuclear cells are syngeneic with respect to a subject.
  • the peripheral blood mononuclear cells are non-syngeneic with respect to a subject.
  • the non-syngeneic PBMC are xenogeneic or allogeneic with respect to a subject.
  • the anti-third party cells having a T central memory phenotype comprises a CD3 + , CD8 + , CD62L + , CD45RA - , CD45RO + signature.
  • At least 50 % of the isolated population of cells are CD3+CD8+ cells of which at least 50 % have the signature.
  • the malignant disease comprises a leukemia or a lymphoma.
  • the isolated population of cells are syngeneic with the subject.
  • the isolated population of cells are non-syngeneic with the subject.
  • the method further comprises conditioning the subject under sublethal, lethal or supralethal conditions prior to the transplanting.
  • the cell or tissue transplant is syngeneic with the subject.
  • the cell or tissue transplant is derived from a donor selected from the group consisting of an HLA identical allogeneic donor, an HLA non-identical allogeneic donor and a xenogeneic donor.
  • the cell or tissue transplant comprises immature hematopoietic cells.
  • the cell or tissue transplant is selected from the group consisting of a liver, a pancreas, a spleen, a kidney, a heart, a lung, a skin, an intestine and a lymphoid/hematopoietic tissue or organ.
  • the cell or tissue transplant comprises a co-transplantation of several organs.
  • the co-transplantation comprises transplantation of immature hematopoietic cells and a solid organ.
  • the immature hematopoietic cells and the solid organ or obtained from the same donor.
  • the immature hematopoietic cells are transplanted prior to, concomitantly with, or following the transplantation of the solid organ
  • the isolated population of cells are administered prior to, concomitantly with, or following the cell or tissue transplant.
  • the isolated population of cells are syngeneic with the subject.
  • the isolated population of cells are non-syngeneic with the subject.
  • the cell or tissue transplant and the isolated population of cells are derived from the same donor.
  • the cell or tissue transplant is syngeneic with the subject and the isolated population of cells are non-syngeneic with the subject.
  • the cell or tissue transplant is syngeneic with the subject and the isolated population of cells are syngeneic with the subject.
  • the isolated population of cells are administered prior to, concomitantly with, or following the immature hematopoietic cells.
  • the immature hematopoietic cells and the isolated population of cells are derived from the same donor.
  • the donor is non-syngeneic with the subject.
  • the immature hematopoietic cells and the isolated population of cells are derived from the subject.
  • the method further comprises conditioning the subject under sublethal, lethal or supralethal conditions prior to the transplanting.
  • the subject is a human subject.
  • the percentage of B lymphoblast line cells killing was calculated by the following formula: 1 ⁇ The number of live B lymphoblast line cells in the assessed well The number of live B lymphoblast line cells in the control well ⁇ 100
  • Negative values signify that the B-cell lymphoblastoid cell lines proliferated in the presence of Tcm.
  • FIG. 20 depicts the effect of different GMP grade reagents used for isolation of CD8 T cells on levels of K66A killing.
  • H.My C1R HLA A2 K66A mutant transfectant cell lines were incubated for 22 hours with or without anti-3rd party Tcm cells at a 1 to 5 ratio in favor of anti-3rd party Tcm cells. After 22 hours, cells were recovered and analyzed for survival by measuring the number of surviving Calcein+ stained cells a by FACS (mean of two independent experiments). Average percent of killing of H.My C1R HLA A2 K66A mutant cells shown as percent of the levels attained by the optimal control group isolated making use of all four reagents (CD4/CD56/CD19/CD45RA).
  • FIGs. 21-22 are schematic illustrations depicting protocols for generation of Tcm for autologous ( Figure 21 ) and allogeneic ( Figure 22 ) transplantation.
  • FIGs. 23A-D depict a typical experiment demonstrating the role of timing of addition of cytokines on the induction of Tcm phenotype in CD8 T cells stimulated by allogeneic 3 rd party monocyte-derived mature DC.
  • Figure 23A illustrates naive CD8 T cells which were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in a medium containing IL-21 for 3 days.
  • FIG. 23B illustrates naive CD8 T cells which were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 for 7 days.
  • FIG. 23C illustrates CD8 T cells which were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 with continuous presence of IL-21 in both the priming phase (IL21 alone) and in the expansion phase (together with IL-15);
  • Figure 23D illustrates CD8 T cells which were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 with cytokine deprivation for 7 days. Thereafter, the cells received no further activation and were expanded with IL-15 alone until day 13.
  • FIGs. 24A-B depict the role of timing of addition of cytokines in the human allogeneic model; summary of experiments.
  • Cultures were evaluated for cell numbers by trypan blue exclusion ( Figure 24A ), and percentage of Tcm (CD62L+CD45RO+) from CD8 T cells using FACS analysis ( Figure 24B ). For each time point data represents average ⁇ SE of the indicated number (n) of independent experiments.
  • FIG. 25 depicts enrichment of anti-3 rd party specific CD8 T cell by positive selection of CD137+ cells.
  • Naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC (at a ratio of 5.7:1) in the presence of IL-21. After 14 hours of activation, CD137+ cells were positively selected by magnetic sorting. The expression of CD 137 on CD8 T cells was evaluated by FACS.
  • FIG. 26 depicts that enrichment of anti-3 rd party specific CD8 T cell by positive selection of CD137+ cells does not reduce acquisition of Tcm phenotype.
  • Naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 for 3 days. Thereafter, the cells received no further activation and were expanded with IL-7 and IL-15 until day 10 ("Reference control group").
  • naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 5.7:1 in the presence of IL-21. After 14 hours of activation, CD137+ cells were positively selected by magnetic sorting.
  • CD137+ cells were then re-stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 until day 3. Thereafter the cells were expanded with IL-7 and IL-15 until day 10. Cells were evaluated for percentage of Tcm (CD62L+CD45RO+) from CD8 T cells by FACS analysis.
  • FIG. 27 depicts a comparison of proliferation kinetics.
  • Naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 for 3 days. The cells received no further activation thereafter and were expanded with IL-7 and IL-15 until day 14 ("Reference control group").
  • naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 5.7:1 in the presence of IL-21. After 14 hours of activation, CD137+ cells were positively selected by magnetic sorting.
  • CD137+ cells were then re-stimulated with irradiated allogeneic 3rd party DC in at a ratio of 4:1 in the presence of IL-21 until day 3. Thereafter, the cells were expanded with IL-7 and IL-15 until day 10. On day 10, cells were divided into two test groups. In the first group cells continued to be expanded with IL-7 and IL-15 until day 14 ("Anti 3 rd CD137+”) while cells in the second test group were activated with irradiated host PBMC in the presence of IL-7 and IL-15 (at a ratio of 1 to 2). After 24 hours, CD137+ cells were depleted by magnetic sorting. The CD137 depleted cells were re-plated with IL-7 and IL-15 and cultured until day 14 ("Anti 3 rd CD137+ and Anti host CD137-"). On the indicated days, cells were counted by trypan blue exclusion.
  • FIG. 28 depicts depletion of anti-host specific clones by depletion of CD137+ cells after activation with irradiated host PBMC.
  • irradiated host PBMC 9 days after positive selection of anti-3 rd party specific clones, cells were activated by irradiated host PBMC (at a 1:2 ratio, in favor of the host PBMC) in the presence of IL-7 and IL-15. After 24 h, cells were depleted of CD137+ cells. The expression of CD137 on CD8 T cells was evaluated by FACS analysis.
  • FIG. 29 depicts a two stage magnetic sorting technique, based on CD137 upregulation after antigen specific activation of CD8 T cells successfully depletes anti-host clones and increases the percent of cells specific for 3 rd party antigens.
  • Naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 for 3 days. The cells received no further activation thereafter and were expanded with IL-7 and IL-15 until day 14 ("Reference control group").
  • naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 5.7:1 in the presence of IL-21.
  • CD137+ cells were positively selected by magnetic sorting.
  • CD137+ cells were then re-stimulated with irradiated allogeneic 3rd party DC in at a ratio of 4:1 in the presence of IL-21 until day 3.
  • the cells were expanded with IL-7 and IL-15 until day 10.
  • cells were divided into two test groups. In the first group cells continued to be expanded with IL-7 and IL-15 until day 14 ("Anti 3 rd CD137+”) while cells in the second test group were activated with irradiated host PBMC in the presence of IL-7 and IL-15 (at a ratio of 1 to 2).
  • CD137+ cells were depleted by magnetic sorting.
  • the CD137 depleted cells were re plated with IL-7 and IL-15 and cultured until day 14 ("Anti 3 rd CD137+ and Anti host CD137-").
  • Anti 3rd party and anti-host alloreactivity was evaluated by CFSE assay against 3rd party or irradiated host PBMCs.
  • 1 x 10 6 CFSE+ responders were incubated with or without 2 x 10 6 irradiated (20 gy) PBMC stimulators for 84 h in the presence of IL-7. After 84 h, cells were recovered and analyzed for cell division by measuring the number of CFSE low stained CD8 T cells (CD3+CD8+CD56-) cells by FACS.
  • the present invention in some embodiments thereof, relates to tolerance inducing and/or graft versus leukemia reactive anti-third party cells comprising central memory T-lymphocyte phenotype and, more particularly, but not exclusively, to methods of generating same and to the use of same in transplantation and in disease treatment.
  • Tcm anti-third party central memory T
  • autologous Tcm cells which are endowed with anti-disease activity (e.g. anti-tumor activity)
  • allogeneic stimuli e.g. dendritic cells
  • IL-15 and IL-7 IL-15 and IL-7
  • allogeneic Tcm cells which are tolerance inducing cells and are endowed with GVL activity, were generated by first exposing CD8 + T cells to a third party stimuli (e.g. dendritic cells) in the presence of IL-21 for 3 days. Approximately 14 hours from the beginning of culture, the activated cells were selected by positive selection of CD137+, and these cells were re-cultured with IL-21. Subsequently, IL-15 and IL-7 were added to the IL-21 culture with the antigenic stimuli for another 1-2 days. Next, the resultant cells were cultured in an antigen free environment in the presence of IL-21, IL-15 and IL-7 for additional 6-8 days. At the end of culture, the Tcm cells were depleted of alloreactive cells by depletion of CD137+ cells following contacting of the Tcm cells with host type antigen presenting cells (e.g. dendritic cells).
  • a third party stimuli e.g. dendritic cells
  • the cells generated by the present inventors comprised more than 50 % CD3+CD8+ cells of which more than 50 % are Tcm cells (i.e. comprise a CD3 + , CD8 + , CD62L + , CD45RA - , CD45RO + signature see e.g. Example 1 of the Examples section which follows) and comprised TCR independent anti-leukemic activity (see Example 2).
  • an isolated population of cells comprising non-GVHD inducing anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and capable of homing to the lymph nodes following transplantation.
  • Tcm central memory T-lymphocyte
  • isolated population of cells refers to cells which have been isolated from their natural environment (e.g., the human body).
  • non-GVHD refers to having substantially reduced or no graft versus host inducing reactivity.
  • the cells of the present invention are generated as to not significantly cause graft versus host disease (GVHD) as evidenced by survival, weight and overall appearance of the transplanted subject 100 days following transplantation.
  • syngeneic refers to a cell or tissue which is derived from an individual who is essentially genetically identical with the subject. Typically, essentially fully inbred mammals, mammalian clones, or homozygotic twin mammals are syngeneic.
  • syngeneic cells or tissues include cells or tissues derived from the subject (also referred to in the art as "autologous"), a clone of the subject, or a homozygotic twin of the subject.
  • non-syngeneic refers to a cell or tissue which is derived from an individual who is allogeneic or xenogeneic with the subject's lymphocytes.
  • allogeneic refers to a cell or tissue which is derived from a donor who is of the same species as the subject, but which is substantially non-clonal with the subject. Typically, outbred, non-zygotic twin mammals of the same species are allogeneic with each other. It will be appreciated that an allogeneic donor may be HLA identical or HLA non-identical with respect to the subject.
  • xenogeneic refers to a cell or tissue which substantially expresses antigens of a different species relative to the species of a substantial proportion of the lymphocytes of the subject. Typically, outbred mammals of different species are xenogeneic with each other.
  • xenogeneic cells or tissues are derived from a variety of species such as, but not limited to, bovines (e.g., cow), equids (e.g., horse), porcines (e.g. pig), ovids (e.g., goat, sheep), felines (e.g., Felis domestica), canines (e.g., Canis domestica), rodents (e.g., mouse, rat, rabbit, guinea pig, gerbil, hamster) or primates (e.g., chimpanzee, rhesus monkey, macaque monkey, marmoset).
  • bovines e.g., cow
  • equids e.g., horse
  • porcines e.g. pig
  • ovids e.g., goat, sheep
  • felines e.g., Felis domestica
  • canines e.g., Canis domestica
  • rodents e.g.,
  • Cells or tissues of xenogeneic origin are preferably obtained from a source which is known to be free of zoonoses, such as porcine endogenous retroviruses.
  • human-derived cells or tissues are preferably obtained from substantially pathogen-free sources.
  • anti-third party cells refers to lymphocytes (e.g. T lymphocytes) which are directed (e.g. by T cell recognition) against a third party antigen or antigens.
  • third party antigen or antigens refers to a soluble or non-soluble (such as membrane associated) antigen or antigens which are not present in either the donor or recipient, as depicted in detail infra.
  • third party antigens can be third party cells, antigens of viruses, such as for example, Epstein-Barr virus (EBV) or cyto-megalo virus (CMV) or antigens of bacteria, such as flagellin.
  • viruses such as for example, Epstein-Barr virus (EBV) or cyto-megalo virus (CMV)
  • antigens of bacteria such as flagellin.
  • Viral or bacterial antigens can be presented by cells (e.g., cell line) infected therewith or otherwise made to express viral/bacterial proteins.
  • Autologous or non-autologous antigen presenting cells can be used to present short synthetic peptides fused or loaded thereto. Such short peptides may be viral derived peptides or peptides representing any other antigen.
  • Dedicated software can be used to analyze viral or other sequences to identify immunogenic short peptides, i.e., peptides presentable in context of class I MHC or class II MHC.
  • Third party cells can be either allogeneic or xenogeneic with respects to the recipient (explained in further detail hereinbelow).
  • allogeneic third party cells such cells have HLA antigens different from that of the donor but which are not cross reactive with the recipient HLA antigens, such that anti-third party cells generated against such cells are not reactive against a transplant or recipient antigens.
  • the allogeneic or xenogeneic third party cells are stimulatory cells selected from the group consisting of cells purified from peripheral blood lymphocytes (PBL), spleen or lymph nodes, cytokine-mobilized PBLs, in vitro expanded antigen-presenting cells (APC), in vitro expanded dendritic cells (DC) and artificial antigen presenting cells
  • PBL peripheral blood lymphocytes
  • APC in vitro expanded antigen-presenting cells
  • DC dendritic cells
  • the artificial APC of the present invention may be engineered to exhibit autologous MHC with a 3 rd party peptide or a 3 rd party MHC without being pulsed with an exogenous peptide.
  • the artificial APC comprises K562 tumor cells transfected with a third party MHC determinant and a co-stimulatory molecule [as previously described e.g. Suhoski MM et al., Mol Ther. (2007) 15(5): 981-8 ], or fibroblasts transfected with same.
  • Third party antigens can be presented on the cellular, viral or bacterial surfaces or derived and/or purified therefrom. Additionally, a viral or bacterial antigen can be displayed on an infected cell and a cellular antigen can be displayed on an artificial vehicle such as a liposome or an artificial antigen presenting cell (e.g. leukemic or fibroblast cell line transfected with the third party antigen or antigens).
  • an artificial vehicle such as a liposome or an artificial antigen presenting cell (e.g. leukemic or fibroblast cell line transfected with the third party antigen or antigens).
  • the third party antigen may further comprise a synthetic peptide presented by autologous presenting cells, non-autologous presenting cells or on an artificial vehicle or on artificial antigen presenting cells.
  • third party antigens can, for example, be proteins extracted or purified from a variety of sources.
  • An example of a purified protein which can serve as a third party antigen according to the present invention is ovalbumin. Other examples are envisaged.
  • Utilizing cells, viruses, bacteria, virally infected, bacteria infected, viral peptides or bacteria peptides presenting cells as third party antigens is particularly advantageous since such third party antigens include a diverse array of antigenic determinants and as such direct the formation of anti-third party cells of a diverse population, which may further serve in faster reconstitution of T-cells in cases where such reconstitution is required, e.g., following lethal or sublethal irradiation or chemotherapy procedure.
  • anti-disease activity refers to the activity (e.g. killing capability) of the Tcm cells against a diseased cell (e.g. cancer cell, such as graft versus leukemia, GVL, activity). This activity is typically due to TCR independent killing mediated by LFA1-I/CAM1 binding [ Arditti et al., Blood (2005) 105(8):3365-71 . Epub 2004 Jul 6].
  • the third party cells comprise dendritic cells.
  • the third party cells comprise mature dendritic cells.
  • peripheral blood mononuclear cells may be obtained from a third party non-syngeneic cell donor [e.g. in case the Tcm cells are syngeneic, e.g. autologous, the dendritic cells (DCs) may be non-syngeneic, e.g. allogeneic, with respect to the subject; whereas if the Tcm cells are non-syngeneic, e.g.
  • the DCs are selected from a donor being non-syngeneic, e.g. allogeneic, and HLA mismatched with both the subject and the Tcm cells].
  • Monocytes may then be isolated by plastic adherence and cultured (e.g. in cell culture plates) using DC cell medium (e.g. Cellgro DC medium) supplemented with human serum (e.g. 1 % human serum), penicillin/streptomycin and GM-CSF (800 IU/ml) and IL-4 (20 ng/ml) (available from e.g. Peprotech, Hamburg, Germany).
  • DC cell medium e.g. Cellgro DC medium
  • human serum e.g. 1 % human serum
  • penicillin/streptomycin and GM-CSF 800 IU/ml
  • IL-4 20 ng/ml
  • DC medium may be added comprising GM-CSF (1600 IU/ml) and IL-4 (20 ng/ml).
  • non-adherent cells may be harvested, and large cells (mostly immature DC) may be resuspended in fresh medium containing GM-CSF (800 IU/ml), IL-4 (20 ng/ml), LPS (e.g. from E.coli O55:B5 at 10 ng/ml) and IFN ⁇ 100 IU/ml) (available from e.g. Peprotech, Hamburg, Germany), plated and incubated overnight.
  • non-adherent cells may be discarded, and adherent DCs may be gently removed using e.g. cold PBS/1% HS after incubation on ice for 20 minutes, thereby obtaining large cells consisting of mature DC.
  • the third party cells comprise irradiated dendritic cells.
  • the DCs are irradiated with about 5-10 Gy, about 10-20 Gy, about 20-30 Gy, about 20-40 Gy, about 20-50 Gy, about 10-50 Gy. According to a specific embodiment, the DCs are irradiated with about 10-50 Gy (e.g. 30 Gy).
  • the anti-third party cells of the present invention comprise a central memory T-lymphocyte (Tcm) phenotype.
  • Tcm central memory T-lymphocyte
  • central memory T-lymphocyte (Tcm) phenotype refers to a subset of T cytotoxic cells which home to the lymph nodes.
  • the isolated population of cells are CD3+CD8+ cells.
  • the isolated population of cells comprise about 70-90 % CD3+CD8+ cells.
  • At least 30 %, at least 40 %, at least 50 %, at least 55 %, at least 60 %, at least 65 %, at least 70 %, at least 75 %, at least 80 %, at least 85 %, at least 90 %, at least 95 % or even 100 % of the CD3+CD8+ cells have the Tcm cell signature.
  • about 30-80 % of the CD3+CD8+ cells have the Tcm cell signature (e.g. 40-50 %).
  • an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, wherein at least 50 % of the isolated population of cells are CD3+CD8+ cells of which at least 50 % comprise a CD3 + , CD8 + , CD62L + , CD45RA - , CD45RO + signature, and further wherein the cells are tolerance-inducing cells and/or endowed with anti-disease activity (e.g. graft-versus-leukemia (GVL) activity), and capable of homing to the lymph nodes following transplantation.
  • Tcm central memory T-lymphocyte
  • the Tcm cells typically home to the lymph nodes following transplantation.
  • the anti-third party Tcm cells of the present invention may home to any of the lymph nodes following transplantation, as for example, the peripheral lymph nodes and mesenteric lymph nodes.
  • the homing nature of these cells allows them to exert their tolerance effect in a rapid and efficient manner.
  • the anti-third party Tcm cells of the present invention are tolerance-inducing cells.
  • tolerance inducing cells refers to cells which provoke decreased responsiveness of the recipient's cells (e.g. recipient's T cells) when they come in contact with same as compared to the responsiveness of the recipient's cells in the absence of administered tolerance inducing cells.
  • Tolerance inducing cells include veto cells (i.e. T cells which lead to apoptosis of host T cells upon contact with same) as was previously described in PCT Publication Nos. WO 2001/049243 and WO 2002/102971 .
  • the Tcm cells of the present invention may be non-genetically modified cells or genetically modified cells (e.g. cells which have been genetically engineered to express or not express specific genes, markers or peptides or to secrete or not secrete specific cytokines). Any method known in the art may be implemented in genetically engineering the cells, such as by inactivation of the relevant gene/s or by insertion of an antisense RNA interfering with polypeptide expression (see e.g. WO/2000/039294 , which is hereby incorporated by reference).
  • a method of generating the isolated population of cells comprising: (a) contacting peripheral blood mononuclear cells (PBMC) with a third party antigen or antigens in the presence of IL-21 so as to allow enrichment of antigen reactive cells; and (b) culturing the cells resulting from step (a) in the presence of IL-21, IL-15 and IL-7 in an antigen free environment so as to allow proliferation of cells comprising the central memory T-lymphocyte (Tcm) phenotype.
  • PBMC peripheral blood mononuclear cells
  • Tcm central memory T-lymphocyte
  • the anti-third party Tcm cells of the present invention are typically generated by first contacting syngeneic or non-syngeneic peripheral blood mononuclear cells (PBMC) with a third party antigen or antigens (such as described above) in a culture supplemented with IL-21 (otherwise cytokine-free culture i.e., without the addition of any additional cytokines).
  • PBMC peripheral blood mononuclear cells
  • This step is typically carried out for about 12-24 hours, about 12-36 hours, about 12-72 hours, 24-48 hours, 24-36 hours, about 24-72 hours, about 48-72 hours, 1-2 days, 2-3 days, 1-3 days, 2-4 days, 1-5 days, 2-5 days, 2-6 days, 1-7 days, 5-7 days, 2-8 days, 8-10 days or 1-10 days and allows enrichment of antigen reactive cells.
  • contacting of syngeneic or non-syngeneic PBMC with a third party antigen or antigens (such as described above) in a culture supplemented with IL-21 (otherwise cytokine-free culture) is effected for 1-5 days (e.g. 3 days.
  • This step is typically carried out in the presence of about 0.001-3000 ng/ml, 0.001-1000 ng/ml, 0.01-1000 ng/ml, 0.1-1000 ng/ml, 1-1000 ng/ml, 10-1000 ng/ml, 10-500 ng/ml, 10-300 ng/ml, 10-100 ng/ml, 100-1000 ng/ml, 1-100 ng/ml, 1-50 ng/ml, 1-30 ng/ml, 10-50 ng/ml, 10-30 ng/ml, 10-20 ng/ml, 20-30 ng/ml, 20-50 ng/ml, 30-50 ng/ml, 30-100 ng/ml, 1-10 ng/ml, 0.1-10 ng/ml, 0.1-100 ng/ml, 1 ng/ml, 10 ng/ml-100 ng/ml IL-21.
  • the concentration of IL-21 is 10-50 ng/ml (e
  • contacting the syngeneic or non-syngeneic PBMC with a third party antigen or antigens is effected in a cytokine free culture (e.g. supplemented with only IL-21), such a culture condition enables survival and enrichment of only those cells which undergo stimulation and activation by the third party antigen or antigens (i.e. of antigen reactive cells) as these cells secrete cytokines (e.g. IL-2) which enable their survival (all the rest of the cells die under these culture conditions).
  • cytokine free culture e.g. supplemented with only IL-21
  • cytokines e.g. IL-2
  • the ratio of third party antigen or antigens (e.g. dendritic cell) to PBMC is typically about 1:2 to about 1:10 such as about 1:4, about 1:6, about 1:8 or about 1:10. According to a specific embodiment, the ratio of third party antigen or antigens (e.g. dendritic cell) to PBMC is about 1:2 to about 1:8 (e.g. 1:4).
  • the anti-third party cells are cultured in the presence of IL-21, IL-15 and IL-7 in an antigen free environment so as to allow proliferation of cells comprising the Tcm phenotype.
  • This step is typically carried out for about 12-24 hours, about 12-36 hours, about 12-72 hours, 24-48 hours, 24-36 hours, about 24-72 hours, about 48-72 hours, 1-20 days, 1-15 days, 1-10 days, 1-5 days, 5-20 days, 5-15 days, 5-10 days, 1-2 days, 2-3 days, 1-3 days, 2-4 days, 2-5 days, 2-8 days, 2-10 days, 4-10 days, 4-8 days, 6-8 days, 8-10 days, 7-9 days, 7-11 days, 7-13 days, 7-15 days, 10-12 days, 10-14 days, 12-14 days, 14-16 days, 14-18 days, 16-18 days or 18-20 days.
  • the anti-third party cells are cultured in the presence of IL-21, IL-15 and IL-7 in an antigen free environment for about 7-11 days (e.g. 8 days
  • This step is typically carried out in the presence of IL-21 at a concentration of about 0.001-3000 ng/ml, 0.001-1000 ng/ml, 0.01-1000 ng/ml, 0.1-1000 ng/ml, 1-1000 ng/ml, 10-1000 ng/ml, 10-500 ng/ml, 10-300 ng/ml, 10-100 ng/ml, 100-1000 ng/ml, 1-100 ng/ml, 1-50 ng/ml, 1-30 ng/ml, 10-50 ng/ml, 10-30 ng/ml, 10-20 ng/ml, 20-30 ng/ml, 20-50 ng/ml, 30-50 ng/ml, 30-100 ng/ml, 1-10 ng/ml, 0.1-10 ng/ml, 0.1-100 ng/ml, 1 ng/ml-100 ng/ml IL-21.
  • the concentration of IL-21 is 10-50 ng/ml (
  • This step is further carried out in the presence of IL-15 at a concentration of about 0.001-3000 ng/ml, 0.001-1000 ng/ml, 0.01-1000 ng/ml, 0.05-1000 ng/ml, 0.1-1000 ng/ml, 0.5-1000 ng/ml, 0.05-500 ng/ml, 0.5-500 ng/ml, 0.1-100 ng/ml, 0.1-10 ng/ml, 0.5-100 ng/ml, 1-100 ng/ml, 5-100 ng/ml, 1-50 ng/ml, 5-50 ng/ml, 1-10 ng/ml, 5-10 ng/ml, 1-5 ng/ml, 2-3 ng/ml, 2-5 ng/ml, 2-7 ng/ml, 3-5 ng/ml, 3-7 ng/ml, 4-5 ng/ml, 5-6 ng/ml, 5-7 ng/ml, 1-8 ng/m
  • This step is further carried out in the presence of IL-7 at a concentration of about 0.001-3000 ng/ml, 0.001-1000 ng/ml, 0.01-1000 ng/ml, 0.05-1000 ng/ml, 0.1-1000 ng/ml, 0.5-1000 ng/ml, 0.05-500 ng/ml, 0.5-500 ng/ml, 0.1-100 ng/ml, 0.1-10 ng/ml, 0.5-100 ng/ml, 1-100 ng/ml, 5-100 ng/ml, 1-50 ng/ml, 5-50 ng/ml, 1-10 ng/ml, 5-10 ng/ml, 1-5 ng/ml, 2-3 ng/ml, 2-5 ng/ml, 2-7 ng/ml, 3-5 ng/ml, 3-7 ng/ml, 4-5 ng/ml, 5-6 ng/ml, 5-7 ng/ml, 1-8 ng/m
  • the present inventors have collected through laborious experimentation and screening a number of criteria which may be harnessed towards to improving the proliferation of anti-third party cells comprising a central memory T-lymphocyte (Tcm) phenotype being devoid of graft versus host (GVH) reactive cells and/or being enhanced for anti-disease (e.g. GVL) reactive cells.
  • Tcm central memory T-lymphocyte
  • GVH graft versus host
  • GVL anti-disease
  • the PBMCs are depleted of non-adherent cells prior to contacting with a third party antigen or antigens in the presence of IL-21.
  • the PBMCs are depleted of CD4+ and/or CD56+ cells prior to contacting with a third party antigen or antigens in the presence of IL-21.
  • the PBMCs are selected for CD45RA+ cells prior to contacting with a third party antigen or antigens in the presence of IL-21.
  • CD4 + and/or CD56+ cells may be carried out using any method known in the art, such as by affinity based purification (e.g. such as by the use of MACS beads, FACS sorter and/or capture ELISA labeling). Such a step may be beneficial in order to increase the purity of the CD8 + cells within the culture (i.e. eliminate other lymphocytes within the cell culture e.g. T CD4 + cells or NK cells) or in order to increase the number of CD8 + T cells.
  • affinity based purification e.g. such as by the use of MACS beads, FACS sorter and/or capture ELISA labeling.
  • Such a step may be beneficial in order to increase the purity of the CD8 + cells within the culture (i.e. eliminate other lymphocytes within the cell culture e.g. T CD4 + cells or NK cells) or in order to increase the number of CD8 + T cells.
  • the PBMCs comprise non-adherent cells.
  • the PBMCs comprise CD8+ T cells.
  • the PBMCs comprise na ⁇ ve CD8+ T cells.
  • Selection of naive CD8+ T cells may be effected by selection of cells expressing CD45RA+ and/or cells expressing CD45RO- and may be carried out using any method known in the art, such as by affinity based purification (e.g. such as by the use of MACS beads, FACS sorter and/or capture ELISA labeling).
  • affinity based purification e.g. such as by the use of MACS beads, FACS sorter and/or capture ELISA labeling.
  • the PBMCs comprise CD45RA+ cells.
  • An additional step which may be carried out in accordance with the present teachings include culturing the PBMCs cells with a third party antigen or antigens in the presence of IL-21, IL-15 and IL-7 prior to removing the third party antigen or antigens from the cell culture (i.e. prior to generating an antigen free environment).
  • This step is typically carried out for about 12-24 hours, about 12-36 hours, about 12-72 hours, 24-48 hours, 24-36 hours, about 24-72 hours, about 48-72 hours, 1-2 days, 2-3 days, 1-3 days, 2-4 days, 1-5 days or 2-5 days, and is effected at the same doses of IL-21, IL-15 and IL-7 indicated above.
  • culturing the PBMCs cells with a third party antigen or antigens in the presence of IL-21, IL-15 and IL-7 is carried out for 12 hours to 4 days (e.g. 1-2 days).
  • an additional two step process which allows selection and isolation of activated cells may be carried out.
  • Such a selection step aids in removal of potential host reactive T cells in situations where the PBMCs are non-syngeneic with respect to the subject (as described in further detail below).
  • isolating activated cells may be carried out in a two stage approach.
  • activated cells are selected before culturing the cells in the presence of IL-15 and IL-7.
  • This first stage is typically carried out after the initial contacting of the PBMC with a third party antigen or antigens in the presence of IL-21. This selection process picks only those cells which were activated by the third party antigen (e.g.
  • the selection process is effected about 12-24 hours (e.g. 14 hours) after the initial contacting of the PBMC with a third party antigen or antigens.
  • Isolating activated cells may be effected by affinity based purification (e.g. such as by the use of MACS beads, FACS sorter and/or capture ELISA labeling) and may be effected towards any activation markers including cell surface markers such as, but not limited to, CD69, CD44, CD25, CFSE, CD137 or non-cell surface markers such as, but not limited to, IFN- ⁇ and IL-2.
  • Isolating activated cells may also be effected by morphology based purification (e.g. isolating large cells) using any method known in the art (e.g. by FACS). Typically, the activated cells are also selected for expression of CD8 + cells. Furthermore, any combination of the above methods may be utilized to efficiently isolate activated cells.
  • selecting for activated cells is effected by selection of CD137+ and/or CD25+ cells.
  • the second stage of isolation of activated cells is typically carried out at the end of culturing (i.e. after culturing in an antigen free environment with IL-21, IL-15 and IL-7).
  • This stage depletes alloreactive cells by depletion of those cells which were activated following contacting of the central memory T-lymphocyte (Tcm) with irradiated host antigen presenting cells (APCs e.g. dendritic cells).
  • Tcm central memory T-lymphocyte
  • APCs irradiated host antigen presenting cells
  • isolating activated cells may be effected by affinity based purification (e.g.
  • any activation markers including cell surface markers such as, but not limited to, CD69, CD44, CD25, CFSE, CD137 or non-cell surface markers such as, but not limited to, IFN- ⁇ and IL-2.
  • depleting the alloreactive cells is effected by depletion of CD137+ and/or CD25+ cells.
  • a method of generating an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being tolerance-inducing cells and/or endowed with anti-disease activity (e.g.
  • graft-versus-leukemia activity
  • the method comprising: (a) treating non-adherent peripheral blood mononuclear cells (PBMC) with an agent capable of depleting CD4+ and/or CD56+ cells so as to obtain CD8+ T cells; (b) contacting the CD8+ T cells with third party dendritic cells in the presence of IL-21 for 12 hours to 5 days so as to allow enrichment of antigen reactive cells; (c) culturing the cells resulting from step (b) with the third party dendritic cells in the presence of IL-21, IL-15 and IL-7 for 12 hours to 3 days; and (d) culturing the cells resulting from step (c) in the presence of IL-21, IL-15 and IL-7 in an antigen free environment for 5-20 days so as to allow proliferation of cells comprising the central memory T-lymphocyte (Tcm) phenotype.
  • PBMC peripheral blood mononuclear cells
  • Tcm central memory T-lymphocyte
  • the above describe protocol is typically used for no-syngeneic transplantation and therefore the PBMC used are typically allogeneic with respect to a subject (e.g. from an allogeneic donor).
  • a method of generating an isolated population of cells comprising anti-third party cells having a central memory T-lymphocyte (Tcm) phenotype, the cells being endowed with anti-disease activity (e.g.
  • the method comprising: (a) treating non-adherent peripheral blood mononuclear cells (PBMC) with an agent capable of depleting CD4+ and/or CD56+ cells so as to obtain CD8+ T cells; (b) contacting the CD8+ T cells with non-syngeneic dendritic cells in the presence of IL-21 for 12 hours to 5 days so as to allow enrichment of antigen reactive cells; (c) culturing the cells resulting from step (b) with the non-syngeneic dendritic cells in the presence of IL-21, IL-15 and IL-7 for 12 hours to 3 days; and (d) culturing the cells resulting from step (c) in the presence of IL-21, IL-15 and IL-7 in an antigen free environment for 5-20 days so as to allow proliferation of cells comprising the central memory T-lymphocyte (Tcm) phenotype.
  • PBMC peripheral blood mononuclear cells
  • Tcm central memory T-lymphocyte
  • the above describe protocol is typically used for syngeneic transplantation and therefore the PBMC used are typically autologous with respect to a subject (e.g. from the subject).
  • the PBMC may be syngeneic or non-syngeneic with respect to a subject.
  • the non-syngeneic PBMCs of the present invention may be allogeneic or xenogeneic with respect to the subject (explained in further detail hereinbelow).
  • the source of the PBMCs will be determined with respect to the intended use of the cells (see further details hereinbelow) and is well within the capability of one skilled in the art, especially in light of the detailed disclosure provided herein.
  • tolerance inducing cells is especially beneficial in situations in which there is a need to eliminate graft rejection and overcome graft versus host disease (GVHD), such as in transplantation of allogeneic or xenogeneic cells or tissues.
  • GVHD graft versus host disease
  • a method of treating a subject in need of a cell or tissue transplantation comprising transplanting a cell or organ transplant into the subject and administering to the subject a therapeutically effective amount of the isolated population of cells.
  • treating includes abrogating, substantially inhibiting, slowing or reversing the progression of a condition, substantially ameliorating clinical or aesthetical symptoms of a condition or substantially preventing the appearance of clinical or aesthetical symptoms of a condition.
  • the term "subject” or “subject in need thereof” refers to a mammal, preferably a human being, male or female at any age that is in need of a cell or tissue transplantation or suffers from a disease which may be treated with the Tcm cells.
  • the subject is in need of cell or tissue transplantation (also referred to herein as recipient) due to a disorder or a pathological or undesired condition, state, or syndrome, or a physical, morphological or physiological abnormality which is amenable to treatment via cell or tissue transplantation. Examples of such disorders are provided further below.
  • tissue transplantation refers to a bodily cell (e.g. a single cell or a group of cells) or tissue (e.g. solid tissues/organs or soft tissues, which may be transplanted in full or in part).
  • tissue or organs which may be transplanted according to the present teachings include, but are not limited to, liver, pancreas, spleen, kidney, heart, lung, skin, intestine and lymphoid/hematopoietic tissues (e.g. lymph node, Peyer's patches thymus or bone marrow).
  • Exemplary cells which may be transplanted according to the present teachings include, but are not limited to, immature hematopoietic cells including stem cells.
  • the present invention also contemplates transplantation of whole organs, such as for example, kidney, heart, liver or skin.
  • the method may be effected using a cell or tissue which is syngeneic or non-syngeneic with the subject.
  • both the subject and the donor are humans.
  • the cells or tissues of the present invention may be obtained from a prenatal organism, postnatal organism, an adult or a cadaver donor. Moreover, depending on the application needed the cells or tissues may be naive or genetically modified. Such determinations are well within the ability of one of ordinary skill in the art
  • Any method known in the art may be employed to obtain a cell or tissue (e.g. for transplantation).
  • Transplanting the cell or tissue into the subject may be effected in numerous ways, depending on various parameters, such as, for example, the cell or tissue type; the type, stage or severity of the recipient's disease (e.g. organ failure); the physical or physiological parameters specific to the subject; and/or the desired therapeutic outcome.
  • various parameters such as, for example, the cell or tissue type; the type, stage or severity of the recipient's disease (e.g. organ failure); the physical or physiological parameters specific to the subject; and/or the desired therapeutic outcome.
  • Transplanting a cell or tissue transplant of the present invention may be effected by transplanting the cell or tissue transplant into any one of various anatomical locations, depending on the application.
  • the cell or tissue transplant may be transplanted into a homotopic anatomical location (a normal anatomical location for the transplant), or into an ectopic anatomical location (an abnormal anatomical location for the transplant).
  • the cell or tissue transplant may be advantageously implanted under the renal capsule, or into the kidney, the testicular fat, the sub cutis, the omentum, the portal vein, the liver, the spleen, the heart cavity, the heart, the chest cavity, the lung, the skin, the pancreas and/or the intra abdominal space.
  • a liver tissue according to the present teachings may be transplanted into the liver, the portal vein, the renal capsule, the sub-cutis, the omentum, the spleen, and the intra-abdominal space. Transplantation of a liver into various anatomical locations such as these is commonly practiced in the art to treat diseases amenable to treatment via hepatic transplantation (e.g. hepatic failure).
  • transplanting a pancreatic tissue according to the present invention may be advantageously effected by transplanting the tissue into the portal vein, the liver, the pancreas, the testicular fat, the sub-cutis, the omentum, an intestinal loop (the subserosa of a U loop of the small intestine) and/or the intra-abdominal space.
  • Transplantation of pancreatic tissue may be used to treat diseases amenable to treatment via pancreatic transplantation (e.g. diabetes).
  • transplantation of tissues such as a kidney, a heart, a lung or skin tissue may be carried out into any anatomical location described above for the purpose of treating recipients suffering from, for example, renal failure, heart failure, lung failure or skin damage (e. g., burns).
  • the method of the present invention may also be used, for example, for treating a recipient suffering from a disease requiring immature hematopoietic cell transplantation.
  • immature autologous, allogeneic or xenogeneic hematopoietic cells which can be derived, for example, from bone marrow, mobilized peripheral blood (by for example leukapheresis), fetal liver, yolk sac and/or cord blood of the donor and which are preferably T-cell depleted CD34+ immature hematopoietic cells, can be transplanted to a recipient suffering from a disease.
  • Such a disease includes, but is not limited to, leukemia such as acute lymphoblastic leukemia (ALL), acute nonlymphoblastic leukemia (ANLL), acute myelocytic leukemia (AML) or chronic myelocytic leukemia (CML), severe combined immunodeficiency syndromes (SCID), including adenosine deaminase (ADA), osteopetrosis, aplastic anemia, Gaucher's disease, thalassemia and other congenital or genetically-determined hematopoietic abnormalities.
  • ALL acute lymphoblastic leukemia
  • ANLL acute nonlymphoblastic leukemia
  • AML acute myelocytic leukemia
  • CML chronic myelocytic leukemia
  • SCID severe combined immunodeficiency syndromes
  • ADA adenosine deaminase
  • osteopetrosis aplastic anemia
  • Gaucher's disease thalassemia
  • thalassemia congenital
  • the immature autologous, allogeneic or xenogeneic hematopoietic cells of the present invention may be transplanted into a recipient using any method known in the art for cell transplantation, such as but not limited to, cell infusion (e.g. I.V.) or via an intraperitoneal route.
  • cell infusion e.g. I.V.
  • intraperitoneal route e.g. I.V.
  • a cell or tissue transplant of the present invention when transplanting a cell or tissue transplant of the present invention into a subject having a defective organ, it may be advantageous to first at least partially remove the failed organ from the subject so as to enable optimal development of the transplant, and structural/functional integration thereof with the anatomy/physiology of the subject.
  • the immature hematopoietic cells and the isolated population of cells are derived from the same donor.
  • the immature hematopoietic cells and the isolated population of cells are derived from the same subject.
  • the method of the present invention also envisions co-transplantation of several organs (e.g. heart and lung tissues) in case the subject may be beneficially effected by such a procedure.
  • organs e.g. heart and lung tissues
  • the co-transplantation comprises transplantation of immature hematopoietic cells and a solid tissue/organ or a number of solid organs/tissues.
  • the immature hematopoietic cells and the solid organ or obtained from the same donor are provided.
  • the immature hematopoietic cells and the solid organ/tissue or organs/tissue are obtained from different (non-syngeneic) donors.
  • the immature hematopoietic cells are transplanted prior to, concomitantly with, or following the transplantation of the solid organ
  • hematopoietic chimerism is first induced in the subject by transplantation of immature hematopoietic cells in conjunction with the Tcm cells of the present invention, leading to tolerance of other tissues/organs transplanted from the same donor.
  • the Tcm cells of the present invention are used per se for reduction of rejection of transplanted tissues/organs organs transplanted from the same donor.
  • the cell or tissue transplant and the isolated population of cells are derived from the same donor.
  • the cell or tissue transplant is syngeneic with the subject and the isolated population of cells are non-syngeneic with the subject.
  • the cell or tissue transplant is syngeneic with the subject and the isolated population of cells are syngeneic with the subject.
  • pancreatic tissue transplant may be monitored following transplantation by standard pancreas function tests (e.g. analysis of serum levels of insulin).
  • a liver tissue transplant may be monitored following transplantation by standard liver function tests (e.g. analysis of serum levels of albumin, total protein, ALT, AST, and bilirubin, and analysis of blood-clotting time).
  • Structural development of the cells or tissues may be monitored via computerized tomography, or ultrasound imaging.
  • the method may further advantageously comprise conditioning the subject under sublethal, lethal or supralethal conditions prior to the transplanting.
  • the terms "sublethal”, “lethal”, and “supralethal”, when relating to conditioning of subjects of the present invention, refer to myelotoxic and/or lymphocytotoxic treatments which, when applied to a representative population of the subjects, respectively, are typically: non-lethal to essentially all members of the population; lethal to some but not all members of the population; or lethal to essentially all members of the population under normal conditions of sterility.
  • the conditioning step is effected by conditioning the subject under supralethal conditions, such as under myeloablative conditions.
  • the conditioning step may be effected by conditioning the subject under lethal or sublethal conditions, such as by conditioning the subject under myeloreductive conditions.
  • conditioning agents which may be used to condition the subject include, without limitation, irradiation, pharmacological agents, and tolerance-inducing cells (as described herein).
  • Examples of pharmacological agents include myelotoxic drugs, lymphocytotoxic drugs and immunosuppressant drugs.
  • myelotoxic drugs include, without limitation, busulfan, dimethyl mileran, melphalan and thiotepa.
  • the method may further advantageously comprise conditioning the subject with an immunosuppressive regimen prior to, concomitantly with, or following transplantation of the cell or tissue transplant.
  • immunosuppressive regimens include administration of immunosuppressive drugs, tolerance inducing cell populations (as described in detail hereinbelow), and/or immunosuppressive irradiation.
  • the immunosuppressive regimen consists of administering at least one immunosuppressant agent to the subject.
  • immunosuppressive agents include, but are not limited to, methotrexate, cyclophosphamide, cyclosporine, cyclosporin A, chloroquine, hydroxychloroquine, sulfasalazine (sulphasalazopyrine), gold salts, D-penicillamine, leflunomide, azathioprine, anakinra, infliximab (REMICADE), etanercept, TNF.alpha. blockers, a biological agent that targets an inflammatory cytokine, and Non-Steroidal Anti-Inflammatory Drug (NSAIDs).
  • methotrexate cyclophosphamide
  • cyclosporine cyclosporin A
  • chloroquine hydroxychloroquine
  • sulfasalazine sulphasalazopyrine
  • gold salts gold salts
  • D-penicillamine leflunomide
  • azathioprine anakin
  • NSAIDs include, but are not limited to acetyl salicylic acid, choline magnesium salicylate, diflunisal, magnesium salicylate, salsalate, sodium salicylate, diclofenac, etodolac, fenoprofen, flurbiprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, naproxen, nabumetone, phenylbutazone, piroxicam, sulindac, tolmetin, acetaminophen, ibuprofen, Cox-2 inhibitors, tramadol, rapamycin (sirolimus) and rapamycin analogs (such as CCI-779, RAD001, AP23573). These agents may be administered individually or in combination.
  • the method of the present invention utilizes the novel anti third party Tcm cells (as described in detail hereinabove).
  • these anti third party Tcm cells are administered either concomitantly with, prior to, or following the transplantation of the cell or tissue transplant.
  • the anti third party Tcm cells may be administered via any method known in the art for cell transplantation, such as but not limited to, cell infusion (e.g. I.V.) or via an intraperitoneal route.
  • cell infusion e.g. I.V.
  • intraperitoneal route e.g. I.V.
  • a therapeutically effective amount is an amount of anti-third party Tcm cells efficient for tolerization, anti-tumor effect and/or immune reconstitution without inducing GVHD. Since the Tcm cells of the present invention home to the lymph nodes following transplantation, lower amounts of cells (compared to the dose of cells previously used, see for example WO 2001/049243 ) may be needed to achieve the beneficial effect/s of the cells (e.g. tolerization, anti-tumor effect and/or immune reconstitution). It will be appreciated that lower levels of immunosuppressive drugs may be needed in conjunction with the Tcm cells of the present invention (such as exclusion of rapamycin from the therapeutic protocol).
  • the therapeutically effective amount or dose can be estimated initially from in vitro and cell culture assays.
  • a dose can be formulated in animal models to achieve a desired concentration or titer. Such information can be used to more accurately determine useful doses in humans.
  • the number of anti-third party Tcm cells infused to a recipient should be more than 1 x 10 4 /Kg body weight.
  • the number of anti-third party Tcm cells infused to a recipient should typically be in the range of 1 x 10 3 /Kg body weight to 1 x 10 4 /Kg body weight, range of 1 x 10 4 /Kg body weight to 1 x 10 5 /Kg body weight, range of 1 x 10 4 /Kg body weight to 1 x 10 6 /Kg body weight, range of 1 x 10 4 /Kg body weight to 1 x 10 7 /Kg body weight, range of 1 x 10 4 /Kg body weight to 1 x 10 8 /Kg body weight, range of 1 x 10 3 /Kg body weight to 1 x 10 5 /Kg body weight, range of 1 x 10 4 /Kg body weight to 1 x 10 6 /Kg body weight, range of 1 x 10 6 /
  • novel anti-third party Tcm cells of the present invention may be used as adjuvant therapy for a cell or tissue transplant (as described hereinabove).
  • novel Tcm cells of the present invention are also endowed with anti-disease activity (e.g. anti-tumor cell activity, as described in further detail hereinabove) and thus may be used per se for disease treatment.
  • syngeneic cells in order to obtain a graft versus diseased cell activity (e.g. anti-tumor effect such as anti-leukemia treatment), syngeneic cells as well as non-syngeneic cells may be used.
  • the method of the present invention may be applied to treat any disease such as, but not limited to, a malignant disease, a disease associated with transplantation of a graft, an infectious disease such as a viral disease or a bacterial disease, an inflammatory disease and/or an autoimmune disease.
  • malignant diseases such as leukemia [e.g., acute lymphatic, acute lymphoblastic, acute lymphoblastic pre-B cell, acute lymphoblastic T cell leukemia, acute - megakaryoblastic, monocytic, acute myelogenous, acute myeloid, acute myeloid with eosinophilia, B cell, basophilic, chronic myeloid, chronic, B cell, eosinophilic, Friend, granulocytic or myelocytic, hairy cell, lymphocytic, megakaryoblastic, monocytic, monocytic-macrophage, myeloblastic, myeloid, myelomonocytic, plasma cell, pre-B cell, promyelocytic, subacute, T cell, lymphoid neoplasm, predisposition to myeloid malignancy, acute nonlymphocytic leukemia
  • leukemia e.g., acute lymphatic, acute lymphoblastic
  • infectious diseases including, but are not limited to, chronic infectious diseases, subacute infectious diseases, acute infectious diseases, viral diseases (e.g. EBV, CMV, HIV), bacterial diseases, protozoan diseases, parasitic diseases, fungal diseases, mycoplasma diseases and prion diseases; inflammatory diseases (e.g. chronic inflammatory diseases and acute inflammatory diseases); and autoimmune diseases (e.g. cardiovascular diseases, rheumatoid diseases, glandular diseases, gastrointestinal diseases, cutaneous diseases, hepatic diseases, neurological diseases, muscular diseases, nephric diseases, diseases related to reproduction, connective tissue diseases and systemic diseases).
  • infectious diseases including, but are not limited to, chronic infectious diseases, subacute infectious diseases, acute infectious diseases, viral diseases (e.g. EBV, CMV, HIV), bacterial diseases, protozoan diseases, parasitic diseases, fungal diseases, mycoplasma diseases and prion diseases; inflammatory diseases (e.g. chronic inflammatory diseases and acute inflammatory diseases); and autoimmune diseases (e.g. cardiovascular diseases,
  • the method of the present invention can furthermore be advantageously applied towards treating a disease in a subject while concomitantly facilitating engraftment of a transplant of cells or tissues syngeneic with the anti-third party Tcm cells (e.g. in situations where the cell or tissue transplant and the anti-third party cells are derived from the same donor).
  • compositions, method or structure may include additional ingredients, steps and/or parts, but only if the additional ingredients, steps and/or parts do not materially alter the basic and novel characteristics of the claimed composition, method or structure.
  • a compound or “at least one compound” may include a plurality of compounds, including mixtures thereof.
  • range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.
  • method refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical and medical arts.
  • PBMC Peripheral blood mononuclear cells
  • PBMC peripheral blood mononuclear cells
  • H.My2 C1R HLA A2 K66A transfectant cells and H.My2 C1R HLA A2 w.t. transfectant B cell line were used.
  • C1R a human B-cell lymphoblastoid line lacking surface HLA A and B antigens, derived from Hmy.2 B-LCL by gamma irradiation followed by selection for Class I monoclonal antibodies and complement as previously described [ Storkus WJ, et al. Proc. Natl. Acad. Sci. USA (1989) 86: 2361-2364 ] was used.
  • C1R-neo a stable transfectant cell line established in 1987 by electroporation of the C1R cell line with a modified neomycin drug-resistant eukaryotic vector, pSP65-Neo (the vector did not carry an insert), as previously described [ Grumet FC, et al. Hum. Immunol. (1994) 40: 228-234 ] was used.
  • Monocytes were isolated by plastic adherence and cultured in 6-well plates using 3 ml of Cellgro DC medium supplemented with 1 % human serum and penicillin/streptomycin plus GM-CSF (800 IU/ml) and IL-4 (20 ng/ml) (Peprotech, Hamburg, Germany). After 48 h of culture, 1.5 ml of medium was added (+GM-CSF at 1600 IU/ml and IL4 at 20 ng/ml).
  • GM-CSF 800 IU/ml
  • IL-4 20 ng/ml
  • non-adherent cells were harvested, and large cells (mostly immature DC) were counted, resuspended in fresh medium containing GM-CSF 800 IU/ml, IL-4 20 ng/ml, LPS from E.coli O55 :B5 at 10 ng/ml (Sigma, Deisenhofen, Germany) and IFN ⁇ (Peprotech,100 IU/ml), and plated at approximately 106 DC per well in 2 ml and incubated overnight. The next day, non-adherent cells were discarded, and adherent DC were gently removed using cold PBS/1 % HS after incubation on ice for 20 minutes. Large cells consisting of mature DC were counted. The cells were irradiated with 30 Gy to avoid outgrowth of few potentially contaminating NK- or memory T-cells and were then used for T-cell stimulation.
  • Na ⁇ ve CD8 T cells were isolated by initial negative selection using a CD8 negative selection kit (Miltenyi, Bergisch Gladbach, Germany) according to the manufacturer's instructions. Antigen-experienced CD8+ T-cells were then depleted using CD45RO- beads and on LD column.
  • Naive CD8 T cells were isolated and resuspended in T-cell medium supplemented with IL-21 (Peprotech, 30 ng/ml). Irradiated DCs were added at a 1:4 DC:T-cell ratio with 4 x 10 5 T-cells per well of a 48-well plate. Total volume of each well was 500 ⁇ l.
  • T-cell medium with IL-7 and IL-15 500 ⁇ l T-cell medium with IL-7 and IL-15 (Peprotech, 5 ng/ml final concentrations) were added and cells were subsequently fed every 2-3 days as outline in the results section.
  • H.My C1R (“Neo") and H.My C1R HLA A2 K66A mutant transfectant (“K66A”)
  • B lymphoblast line cells were obtained by Ficoll density gradient centrifugation and were labeled with 0.15 ⁇ g/mlCalceinAM (Molecular Probes, Inc, Eugene, OR), a vital dye that is released upon cell death, according to manufacturer's instructions.
  • 2 x 10 5 Calcein labeled B lymphoblast line cells were incubated with or without anti-3 rd party Tcm for 22 hours at a 1 to 5 ratio in favor of anti-3 rd party Tcms in 24 well plates.
  • Tcm Prior to the co culture anti-3 rd party Tcm were enriched for CD8+ T cells by a negative selection kit (Miltenyi, Bergisch Gladbach, Germany). No exogenous cytokines were added to the MLR. Cells were recovered and analyzed for survival by measuring the number of surviving Calcein stained B lymphoblast line cells by FACS. For detection of apoptosis by AnnexinV+ samples were incubated with 5 ⁇ l AnnexinV-APC (BD) for 15 minutes at room temperature. Subsequently, unbound AnnexinV was washed out, and samples were analyzed by FACS.
  • BD AnnexinV-APC
  • the percentage of B lymphoblast line cells killing was calculated by the following formula: 1 ⁇ The number of live B lymphoblast line cells in the assessed well The number of live B lymphoblast line cells in the control well ⁇ 100
  • Naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 6:1 in the presence of IL-21 (Peprotech, 30 ng/ml). After 14 hours of activation, CD137+ cells were positively selected by magnetic sorting (Miltenyi, Bergisch Gladbach, Germany). CD137+ cells were then re-stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 (Peprotech, 30 ng/ml) until day 3. Thereafter, the cells were expanded with 5 ng/ml IL-7 and 5 ng/ml IL-15 (Peprotech) until day 10. On day 10, cells were divided into two test groups.
  • cells in the first group continued to be expanded with IL-7 and IL-15 until day 14, while cells in the second test group were activated with irradiated host PBMC in the presence of IL-7 and IL-15 (at a ratio of 1 to 2).
  • IL-7 and IL-15 at a ratio of 1 to 2.
  • CD137+ cells were depleted by magnetic sorting.
  • the CD137 depleted cells were re plated with IL-7 and IL-15 and cultured until day 14 ("Anti 3 rd CD137+ and Anti host CD137-").
  • Anti 3rd party and anti-host alloreactivity was evaluated by CFSE assay against 3rd party or irradiated host PBMCs.
  • Tcm T central memory
  • CTLs cytotoxic T lymphocytes
  • Tcm central memory T cells
  • anti-3 rd party Tcm can be administrated together with autologous BMT.
  • the patient's own CD8+ T cells are isolated and stimulated against allogeneic dendritic cells from an allogeneic donor.
  • anti-3 rd party Tcm can be transplanted together with allogeneic T depleted BM cells.
  • Naive CD8+ T cells originating from the allogeneic BM donor serve as responders and 3 rd party donor dendritic cells are used as stimulators to enable the generation of host non-reactive Tcm.
  • the 3 rd party donor is selected so as to insure that none of his HLA class I alleles are shared with the HLA class I alleles of the host.
  • a new protocol was developed based on three major steps: a) Selection of CD8 T cells from PBMC; b) Stimulation against allogeneic dendritic cells (DC) for 3 days in the presence of IL-21; and c) Expansion in an antigen free environment with IL-7, IL-15 and IL-21 for an additional 8 days.
  • DC allogeneic dendritic cells
  • Table 1 Comparison of autologous human protocol versus the syngeneic mouse protocol for generation of Tcm Human Mouse Parameters Major stages
  • Cytokines Co -Culture ( Priming ) Non adherent cells are transferred to a new plate Ficoll, CD8+ positive selection and plating in a new flask. Co culture is stopped by : Human Mouse Parameters Major stages IL-7, IL-15, IL-21 IL-15 Cytokines Antigen free Expansion NO YES Positive selection of CD62L+ Cells at the end of culture
  • the present approach was based on stimulation against antigen pulsed DC in the presence of IL-21 for 3 days and subsequent expansion in the presence of IL-7 and IL-15 for an additional 8 days.
  • CD4 + T cells, ⁇ / ⁇ T cells, B cells, NK cells, dendritic cells, monocytes, granulocytes and erythroid cells i.e., CD4 + T cells, ⁇ / ⁇ T cells, B cells, NK cells, dendritic cells, monocytes, granulocytes and erythroid cells
  • the first parameter evaluated was the role of stimulation against a 3 rd party DC. This step was originally intended to reduce the risk for GVHD in the allogeneic setting, by selective expansion of anti-3 rd party clones in the absence of stimulation of anti-host clones mediating GVHD.
  • na ⁇ ve CD8 T cells grown with IL-21 in the absence of allogeneic stimulation by dendritic cells exhibited low proliferation level (2.7 ⁇ 1.1 % of that exhibited by the reference control group), representing on day 7 approximately 0.4 fold expansion from day 0 (most cells died before day 10), and maintaining their naive phenotype (CD45RO-CD62L+, small morphology) (Tcm level was only 10 % from that of reference control group).
  • Table 2 The critical role of DCs as stimulators %Tcm (CD3+CD8+CD62L+CD45RA-) Fold expansion from day 0 (on day 7) Group 92 20.5 Naive CD8 T cells ⁇ (md-mDC) 92 6.75 Naive CD8 T cells ⁇ PBMC 80 16 Un-separated CD8 T cells ⁇ (md-mDC) 77 1.8 Un-separated CD8 T cells ⁇ PBMC MLR culture in which naive CD8 T cells or unseparated CD8 T responders were stimulated against monocyte-derived mature DC (8:1 responder/DC ratio) or PBMC (1:1 responder/PBMC ratio), from the same allogeneic donor, in a medium containing IL-21 for 3 days. Thereafter, the cells were grown with IL-7 and IL-15 until day 7 without further activation. On day 7 of the culture, the different groups were evaluated for percentage of Tcm using FACS analysis and for cell numbers by trypan blue exclusion.
  • the desired population of CD8 T cells represents 21 % of the cells on day 0 after depletion of adhered cells, while the other major "contaminating" subpopulations include CD4 T cells (61 %), B cells (7 %) and NK cells (7 %).
  • CD4 T cells represent the largest contamination, and were previously shown to compete with CD8 T cells; these cells therefore had to be removed.
  • NK cells that are known to expend in IL-15 cultures.
  • B cells tend to die under these culture conditions.
  • potential depletion with anti-CD4 and anti-CD56 magnetic beads was initially evaluated with and without depletion of CD 19+ B cells.
  • PBMC peripheral blood mononuclear cells
  • Adding a second step of positive enrichment of naive cells with anti-CD45RA increased the percent of naive cells (CD45RO-CD45RA+, gated on CD3+CD8+) from 53 % before magnetic sorting to 91 % in both groups.
  • this step did not markedly affect the final level of CD8 T cells, which increased from 60 % to 66 % when using anti-CD4 and anti-CD56, or from 90 % to 94 % when the negative selection step also included anti-CD19.
  • Tcm phenotype attained in the two cultures against different DCs were within the range of the small scale experiments although some variability occurred ( Figures 17A-B ).
  • this level declined more significantly in the culture against the 2 nd DC donor upon the 9th day (65 % vs. 46 %) and day 12 ( 62 % vs. 35 %).
  • This variability which was not observed significantly in the small scale experiments could be explained in part by a relative difficulty to remove the DCs on day 5, as they are less likely to adhere to the plastic bag compared to their adhesion to the plates used in the small scale experiments.
  • the longer presence and stimulation with the DCs could lead to a more pronounced transition from a Tcm to a Teff phenotype.
  • a mixed lymphocyte reaction (MLR) was carried out with anti-3 rd party Tcm targeting B-cell lymphoma and plasma cell leukemia cell lines and the percent apoptotic cells was measured after 22 hours.
  • MLR mixed lymphocyte reaction
  • CD8 T cells were first enriched by extensively depleting non CD8 T cells (i.e., CD4+ T cells, ⁇ / ⁇ T cells, B cells, NK cells, dendritic cells, monocytes, granulocytes, and erythroid cells) using magnetic bead sorting.
  • CD4+ T cells i.e., CD4+ T cells, ⁇ / ⁇ T cells, B cells, NK cells, dendritic cells, monocytes, granulocytes, and erythroid cells
  • Figure 18 representing a typical experiment, the percent of contaminating NK and NKT cells was very low (below 0.1 % for NK cells, and below 1.9 % for NKT cells) for all four groups tested.
  • the highly purified CD8 T cells were then incubated with two types of cells: a) H.My C1R HLA-A2 K66A mutant cell line (K66A) to demonstrate TCR independent killing, and b) H.My C1R (Neo), a B-cell lymphoblastoid line lacking surface HLA A and B antigens and therefore insensitive to killing by Tcm via a mechanism which requires interaction between the CD8 molecule on the Tcm and the ⁇ 3 domain on MHC of the target leukemia cells.
  • anti-3 rd party Tcm could be very useful for tolerance induction in allogeneic BMT [ Ophir E. et al. Blood. (2010) 115(10):2095-104 ].
  • naive CD8+ T cells originating from the allogeneic BM donor serve as responders, and 3 rd party donor dendritic cells (DC) are used as stimulators to enable the generation of host non-reactive Tcm cells.
  • DC dendritic cells
  • the 3 rd party donor is selected so as to ensure that none of his HLA class I alleles are shared with the HLA class I alleles of the host.
  • the protocol for generating Tcm for the allogeneic setting differs from the protocol for the autologous setting in two major steps:
  • naive CD8 T cells exposed to IL-7 and IL-15 proliferate in an antigen independent manner.
  • naive CD8 T cells exposed to IL-21 in the absence of allogeneic stimulation did not proliferate, and did not even survive beyond day 7 of culture. Therefore, delaying the addition of IL-7 and IL-15 from day 3 to day 7 could potentially lead to a selective depletion of anti-host clones not responsive to the 3 rd party stimulators.
  • naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence or absence of IL-21 for 7 days.
  • the cells received no further activation and were expanded with IL-7 and IL-15 ( Figure 23B ), IL-15 and IL-21 ( Figure 23C ), or IL-15 alone ( Figure 23D ) until day 13; the resulting cell populations were compared to the naive CD8 T cells cultured according to the reference control group, expanded as described for the autologous setting (incubation on d (0-3) with IL21 and DC; on d(3-13), addition of IL7+IL15 ( Figure 23A ).
  • the most critical parameter namely depletion of host reactive clones (tested with appropriate donors who are completely distinct in HLA Class I from the 3 rd party cells used for stimulation) are examined. Further experiments to optimize the cytokine deprivation period are also carried out.
  • An elegant way to deplete anti-host clones based on the 3 rd party concept may be achieved by a two stage magnetic sorting technique, comprising the following CD 137 selection steps:
  • CD 137 has been described to be a suitable marker for antigen-specific activation of human CD8 + T cells, as CD137 is not expressed on resting CD8 + T cells and its expression is reliably induced after 24 hours of stimulation.
  • naive CD8 T cells were stimulated with irradiated allogeneic 3rd party DC in the presence of IL-21.
  • CD137+ cells were positively selected by magnetic sorting.
  • CD137+ cells were then re-stimulated with irradiated allogeneic 3rd party DC in the presence of IL-21 until day 3.
  • the cells were expanded with IL-7 and IL-15 until day 10 and, and were then activated with irradiated host PBMC in the presence of IL-7 and IL-15.
  • CD137+ cells were depleted by magnetic sorting.
  • the CD137 depleted cells were re-plated with IL-7 and IL-15 and cultured until day 14.
  • na ⁇ ve CD8 T cells were stimulated with irradiated allogeneic 3rd party DC at a ratio of 5.7:1 in the presence of IL-21.
  • CD137 + cells were positively selected by magnetic sorting.
  • CD137 + cells were then re-stimulated with irradiated allogeneic 3rd party DC at a ratio of 4:1 in the presence of IL-21 until day 3.
  • the cells were expanded with IL-7 and IL-15 until day 10. Cells were evaluated for cell composition by FACS analysis .
  • the test group of CD8 T cells subjected to positive selection of CD137+ cells exhibited superior expansion potential in comparison to the reference control group at both time points (35 vs. 7 fold expansion from day 0 on day 7, respectively, and 119 vs. 34 fold expansion from day 0 on day 10, respectively).
  • the group of CD8 T cells subjected to positive selection of CD137+ cells was divided into two test groups. In the first group, cells continued to be expanded with IL-7 and IL-15 until day 14 ("Anti 3 rd CD137+”), while cells in the second test group were activated with irradiated host PBMC in the presence of IL-7 and IL-15.
  • CD137+ cells were depleted by magnetic sorting. The CD137 depleted cells were then re plated with IL-7 and IL-15 and cultured until day 14 ("Anti 3 rd CD137+ and Anti- host CD137-").
  • CD8 T cells from the test group subjected to positive selection of CD137+ continued to exhibited superior expansion potential in comparison to the reference control group at both time points (134 vs. 61 fold expansion, respectively).
  • CD8 T cells from the test group subjected to both anti-3rd party positive selection of CD137+ and depletion of anti-host CD137+ cells exhibited lower expansion potential when evaluated on day 14 (72 fold expansion) ( Figure 27 ) indicating that cell expansion between days 11 to 14 could not compensate for the loss of cells caused by the depletion of CD137+ anti-host specific alloreactive T cells.
  • the percent of CD8 T cells expressing CD137+ from the total CD8 T cell compartment increased to 16 %.
  • Depletion of these CD137+ cells by magnetic sorting decreased the percent of CD8 T cells expressing CD137 of the total CD8 T cell compartment, from 16 % to 3 %.
  • the number of cells specifically dividing after stimulation with 3 rd party PBMC was approximately 3 times higher in the group subjected to the CD 137 based positive and negative selection compared to the reference control group (2259 vs.741 dividing cells, respectively).
  • the removal of CD 137+ cells towards the end of the culture completely prevented proliferation in response to host PBMC, in contrast to the reference control group which exhibited detectable proliferation (134 dividing cells).
  • CD 137 depletion at the end of Tcm generation might afford a feasible approach to further deplete these cells of alloreactivity.

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